Background: Inadequacy of dialysis is one of the main causes of death in hemodialysis patients. Some studies have suggested that highflux membrane improves the removal of moderate-sized molecules while other studies indicate no significant effect on them. Objectives: This study aimed to investigate the dialysis efficacy of low-flux versus high-flux membranes in hemodialysis patients. Patients and Methods: Forty hemodialysis patients participated in this cross-over clinical trial. Two sessions of low-flux and high-flux membrane dialysis were performed consecutively, in the first and second stage of the trial. In both stages, blood samples before and after the dialysis were taken and sent to the laboratory for assessment. Blood urea nitrogen (BUN), KT/V and the urea reduction ratio (URR) indexes were used to determine dialysis efficacy. Data were analyzed using t test and paired t test. Results: The mean KT/V was 1.27 ± 0.28 in high-flux and 1.10 ± 0.32 in low-flux membrane which, these differences were statistically significant (P = 0.017). The mean of URR was 0.65 ± 0.09 in high-flux and 0.61 ± 0.14 in low-flux membrane, which these differences were not statistically significant (P = 0.221). Conclusions:The high-flux membrane had better dialysis adequacy, so we suggest using high-flux membrane in hemodialysis centers.

We carried out a semi-experimental study with simple randomized sampling to study the effects of applying a continuous care model on the quality of life of 36 spouses of haemodialysis patients in Hamedan, Islamic Republic of Iran. Participants took part in group discussions and training on the continuous care approach and completed the Perceived Quality Of Life (PQOL) questionnaire before and after the intervention. Mean scores on the physical, social and cognitive dimensions, as well as happiness and total scores significantly increased after the intervention. Applying a continuous care model has positive effects on the caregivers of chronic patients.Effets d'un modèle de soins continus sur la qualité de vie ressentie par les conjoints de sujets hémodialysés RÉSUMÉ Nous avons réalisé une étude semi-expérimentale sur la base d'un échantillonnage aléatoire simple afin d'étudier les effets de l'application d'un modèle de soins continus sur la qualité de vie de 36 conjoints de sujets hémodialysés à Hamedan (République islamique d'Iran). Les participants ont participé à des discussions de groupe et à des formations sur le concept de soins continus et ont complété le questionnaire sur la qualité de vie ressentie (PQOL) avant et après l'intervention. Les scores moyens relatifs aux aspects physiques, sociaux et cognitifs, de même que le score relatif au bonheur et les scores totaux, ont augmenté de façon significative après l'intervention. L'application d'un modèle de soins continus a des effets positifs sur les aidants de patients chroniques.

One of the serious complications of COVID-19 is acute kidney injury (AKI), leading to a decrease in kidney function and even death. The concentration of ammonia (NH 3 ) in the exhaled breath (EB) of COVID-19 patients suffering from AKI symptoms will be significantly increased. In this work, the detection of breath NH 3 was performed at gold interdigital electrodes modified with a soluble polypyrrole microparticle and silver nanoparticle film (Au-IDEs/S-PPyMPs/AgNPs) as a noninvasive chemiresistor gas sensor. The response behavior of unmodified and modified gas sensors toward NH 3 and other interfering compounds was studied. The Au-IDEs/S-PPyMPs/AgNPs exhibited NH 3 detection in the linear dynamic range of 1.00−19.23 ppm, with a limit of detection of 0.12 ppm. Finally, the fabricated gas sensor was used to monitor the NH 3 concentration in the EB of COVID-19 patients suffering from AKI symptoms. For this purpose, the gas sensor was validated in 19 EB samples (seven COVID-19−positive patients, four COVID-19−negative patients, and eight post−COVID-19 patients). The gas sensor was directly exposed to the EB samples, followed by recording the changes in electrical resistance via a low-cost digital multimeter. The sensing mechanism was explained as the interaction between breath NH 3 and sensing materials. The breath NH 3 concentrations have a desirable correlation (R 2 = 0.8463) with the estimated glomerular filtration rate (eGFR) values in COVID-19−positive patients. The fabricated gas sensor can distinguish COVID-19−positive patients suffering from AKI symptoms from COVID-19−negative patients and post−COVID-19 patients. The present work can pave the way for the development of a simple and efficient analytical approach for COVID-19 patients with AKI without the need for sample pretreatment.

The most common anatomic variant seen in the donor kidneys for renal transplantation is multiple renal arteries (MRA), which can cause an increased risk of complications. We describe the long-term outcomes of 16 years of experience in 76 kidney transplantations with MRAs. In a new reconstruction technique, we remove arterial clamps after anastomosing the donor to the recipient's main renal vessels, which cause backflow from accessory arteries to prevent thrombosis. By this technique, we reduce the ischemic times as well as the operating times. Both in live or cadaver donor kidneys, lower polar arteries were anastomosed to the inferior epigastric artery and upper polar arteries were anastomosed to the superior epigastric arteries. Injection of Papaverine and ablation of sympathic nerves of these arteries dilate and prevent them from post-operative spasm. Follow-up DTPA renal scan in all patients showed good perfusion and function of the transplanted kidney, except two cases of polar arterial thrombosis. Mean creatinine levels during at least two years of follow-up remained acceptable. Patient and graft survival were excellent. No cases of ATN, hypertension, rejection and urologic complications were found. In conclusion, this technique can be safely and successfully utilized for renal transplantation with kidneys having MRAs, and may be associated with a lower complication rate and better graft function compared with the existing techniques.

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